What are Cervical, Thoracic and Lumbar Discography?
What are the discs?
The discs are cushion-like pads that separate the hard vertebral bones of your spine. A disc may be painful when it presses on nerves or the spinal cord, herniates, tears or degenerates and may cause pain in your neck, mid-back, low back and arms, chest wall, abdomen and legs. Other structures in your spine may also cause similar pain, such as the muscles, joints, and nerves. Usually, we have first determined that these other structures are not the sole pain source (through history and physical examination, review of X-rays, CTs, MRIs, myelograms, and/or other diagnostic injection procedures such as facet and sacroiliac joint injections and nerve root blocks) before performing discography.
What is discography and why is it helpful?
Discography helps confirm or rule out the disc(s) as a source of your pain. This procedure utilizes the placement of a needle into the discs themselves and injecting contrast (dye). CT and MRI scans only demonstrate anatomy and cannot absolutely prove your pain source. In many instances, the discs may be abnormal on MRI or CT scans but not be a source of pain. Only discography can tell if the disc itself is probably a source of your pain. Therefore, discography is done to identify painful disc(s) and help the surgeon plan the correct surgery, or avoid surgery that may not be beneficial. Discography is usually done only if you think your pain is significant enough for you to consider surgery.
What will happen to me during the procedure?
An IV will be started so that antibiotics (to prevent infection) and relaxation medication can be given. The skin will be scrubbed with a cleaning solution. Next, the physician will numb a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, your doctor will direct a small needle using X-ray guidance into the disc space. You may feel temporary discomfort as the needle passes through the muscle or near a nerve root. Your doctor may perform this at more than one disc level. After the needles are in their proper locations, a small amount of contrast (dye) is injected into each disc. Your doctor will ask you about your experience as the dye is being injected. It is important that you describe what you feel as accurately as you can. You need to be alert enough to be aware of and describe the sensations you experience.
What will happen after the procedure?
Immediately afterwards you will be taken to a recovery room or to a CT scan, where additional pictures will be taken. You will be monitored for 30 – 60 minutes. You may be given a prescription for pain medication over the next 2 – 3 days for muscle discomfort that may exist after this procedure. You will not be able to drive the day of your procedure. You will follow up with your physician in the Pain Clinic in 1-2 weeks to discuss the results of the procedure, or be scheduled immediately for another procedure or referral.
General Pre/Post Instructions
You should have nothing to eat for seven hours prior to your procedure. Clear liquids can be taken up to four hours prior to your procedure. Please take your routine medications (i.e., high blood pressure and diabetic medications) with a sip of water at your usual time. If you are on Coumadin, Heparin, Plavix, or any other blood thinners you must notify the office so the timing of these medications can be explained. For your own safety, if you do not follow the above instructions your procedure may be cancelled. A driver must accompany you and be responsible for getting you home. No driving is allowed the day of the procedure. You may return to your normal activities the day after the procedure, including returning to work.